Renal Infarction

Kidney Infarction

Renal infarction is a serious condition due to renal artery occlusion that needs rapid diagnosis, as it may lead to irreversible kidney damage. The diagnosis may be difficult to make, as patients present with nonspecific symptoms.

Symptoms start abruptly and consist of abdominal, flank, costovertebral or lower back pain, nausea, vomiting, fever and sometimes oliguria [4] and hematuria [5]. Blood pressure may be high during the acute episode [6]. Small renal infarction may only cause fatigue [7].

Abstract Patients with fever, flank pain, and dysuria frequently are encountered in the emergency department.[ncbi.nlm.nih.gov]

Abstract A 34-year-old man was admitted for acute onset of left lower abdominal pain associated with fever. His medical history was unremarkable, and the physical examination revealed bilateral flank tenderness.[ncbi.nlm.nih.gov]

We noted abdominal or flank pain in 66 %, fever ( 37.6 C) in 36 %, and nausea/vomiting in 6 % of patients. The white blood cell count, and levels of lactate dehydrogenase and C-reactive protein peaked at 2-4 days after onset.[ncbi.nlm.nih.gov]

[…] an aseptic fever caused by liberation of pyrogens from damaged tissue. intestinal infarction a common occurrence in horses due to occlusion of arteries by larvae of Strongylus vulgaris.[medical-dictionary.thefreedictionary.com]

BACKGROUND: Acute abdominalpain is one of the most frequent complaints evaluated at emergency departments. Approximately 25 % of abdominalpain patients discharged from emergency departments are diagnosed with undifferentiated abdominalpain.[ncbi.nlm.nih.gov]

CONCLUSION: Concomitant presence of flank/abdominalpain, an increased risk for thromboembolism and an elevated LDH suggested a possibility of renal infarction.[ncbi.nlm.nih.gov]

Abstract A 34-year-old man was admitted for acute onset of left lower abdominalpain associated with fever. His medical history was unremarkable, and the physical examination revealed bilateral flank tenderness.[ncbi.nlm.nih.gov]

We report a case of acute renal infarction following coronary angiography in a patient with paroxysmal atrial fibrillation who initially presented with acute abdominalpain mimicking appendicitis.[ncbi.nlm.nih.gov]

A woman who was clinically diagnosed with dermatomyositis complained of severe pain in the right flank of the low back and abdomen, accompanied by nausea and vomiting during corticosteroid therapy.[ncbi.nlm.nih.gov]

The most common symptoms were abdominal pain, flank pain, nausea, and vomiting. Leukocytosis ( 10 10(9)/L) and elevated lactate dehydrogenase levels ( 620 IU/L) were the most prominent laboratory findings.[ncbi.nlm.nih.gov]

We noted abdominal or flank pain in 66 %, fever ( 37.6 C) in 36 %, and nausea/vomiting in 6 % of patients. The white blood cell count, and levels of lactate dehydrogenase and C-reactive protein peaked at 2-4 days after onset.[ncbi.nlm.nih.gov]

Symptoms start abruptly and consist of abdominal, flank, costovertebral or lower back pain, nausea, vomiting, fever and sometimes oliguria and hematuria. Blood pressure may be high during the acute episode.[symptoma.com]

Snapshot A 68-year-old man presents to the emergency room with a 2-day history of abdominal pain, nausea, and vomiting. He denies any urinary frequency or urgency and denies any recent changes in his diet.[medbullets.com]

A woman who was clinically diagnosed with dermatomyositis complained of severe pain in the right flank of the low back and abdomen, accompanied by nausea and vomiting during corticosteroid therapy.[ncbi.nlm.nih.gov]

CASE OUTLINE: A 62-year-old male patient was admitted with a sudden abdominal pain, right flank pain and nausea. He had a diastolic hypertension at admission and his previous medical history showed atrial fibrillation.[ncbi.nlm.nih.gov]

The most common symptoms were abdominal pain, flank pain, nausea, and vomiting. Leukocytosis ( 10 10(9)/L) and elevated lactate dehydrogenase levels ( 620 IU/L) were the most prominent laboratory findings.[ncbi.nlm.nih.gov]

We noted abdominal or flank pain in 66 %, fever ( 37.6 C) in 36 %, and nausea/vomiting in 6 % of patients. The white blood cell count, and levels of lactate dehydrogenase and C-reactive protein peaked at 2-4 days after onset.[ncbi.nlm.nih.gov]

Symptoms start abruptly and consist of abdominal, flank, costovertebral or lower back pain, nausea, vomiting, fever and sometimes oliguria and hematuria. Blood pressure may be high during the acute episode.[symptoma.com]

METHODS/ RESULTS: A 48-year-old man presented with rightflankpain that was unresponsive to analgesia for renal colic. CT scan was performed revealing a partial renal infarction. The etiologic study was only positive to factor V Leiden.[ncbi.nlm.nih.gov]

flankpain who had history of a tendency toward thrombosis revealed extensive renal parenchymal changes secondary to renal infarction and a small size defect in the right kidney in addition to the patient's prior computed tomography results.[ncbi.nlm.nih.gov]

A 42-year-old woman is reported who presented with persistent rightflankpain after an alleged assault with injury to the area 3 weeks previously. Renal infarction necessitated a right nephrectomy that was followed by multiorgan failure and death.[ncbi.nlm.nih.gov]

We present an original case of a 41-year-old man, complaining of acute severe leftflankpain, resistant to common analgesic therapy, who was diagnosed of segmental renal infarction of a branch of left renal artery.[ncbi.nlm.nih.gov]

CASE PRESENTATION: We report the case of a 28-year-old Dalit Nepalese man who presented with sudden onset occipital headache and later developed severe leftflankpain.[ncbi.nlm.nih.gov]

Abstract A 36-year-old diabetic man came to our institution presenting with constant leftflankpain. Left renal embolic infarction was found by abdominal computed tomography.[ncbi.nlm.nih.gov]

We reported a 30-year-old healthy man presenting with sudden onset of leftflankpain. Abdominal plain film and sonography were unremarkable.[ncbi.nlm.nih.gov]

Abstract A 44-year-old Italian man presented to the emergency department on three occasions over 4 days with severe leftflankpain. Initial investigations including a renal tract ultrasound were normal and he was discharged with analgaesia.[ncbi.nlm.nih.gov]

Conservative treatment was initially planned in consideration of the delayed diagnosis ( 3 hours), but the patient subsequently developed hypertension not controllable with anti-hypertensive drugs.[ncbi.nlm.nih.gov]

He had complained of backpain 7 days after the ICD shock. Renal infarction was suspected, although computed tomography and magnetic resonance imaging could not be performed because of chronic renal failure and the presence of his ICD.[ncbi.nlm.nih.gov]

Symptoms start abruptly and consist of abdominal, flank, costovertebral or lower backpain, nausea, vomiting, fever and sometimes oliguria and hematuria. Blood pressure may be high during the acute episode.[symptoma.com]

If patient is suffering from acute renal infarction posse’s low backpain, flank and many more problems, in this stage, clinical treatment is not sufficient but it includes many treatments.[renaltreatment.com]

Renal infarct causes severe flank pain that radiates to lower back and is often mistaken for backpain . In this article, we will study in detail about the causes, symptoms, and treatment options available for treatment of Renal Infarction.[epainassist.com]

If patient is suffering from acute renal infarction posse’s lowbackpain, flank and many more problems, in this stage, clinical treatment is not sufficient but it includes many treatments.[renaltreatment.com]

Subsequently, he was found to have pneumococcal infective endocarditis, pneumococcal pneumonia and bacterial meningitis, namely Austrian syndrome. He underwent an early aortic valve and mitral valve repair but still had a poor clinical outcome.[ncbi.nlm.nih.gov]

Abstract Acute renal infarction is a well known, although relatively unfrequent, cause of flankpain resistant to administration of spasmolytic and nonsteroidal anti-inflammatory drugs.[ncbi.nlm.nih.gov]

CONCLUSION: A high index of suspicion of acute renal infarction is required in patients with risk factors of thrombosis presenting sudden onset flankpain.[ncbi.nlm.nih.gov]

Abstract A 36-year-old diabetic man came to our institution presenting with constant left flankpain. Left renal embolic infarction was found by abdominal computed tomography.[ncbi.nlm.nih.gov]

The most common symptoms were abdominal pain, flankpain, nausea, and vomiting. Leukocytosis ( 10 10(9)/L) and elevated lactate dehydrogenase levels ( 620 IU/L) were the most prominent laboratory findings.[ncbi.nlm.nih.gov]

Symptoms start abruptly and consist of abdominal, flank, costovertebral or lower back pain, nausea, vomiting, fever and sometimes oliguria and hematuria. Blood pressure may be high during the acute episode.[symptoma.com]

After operation, oliguria and renal dysfunction developed, and he was admitted to our hospital because of acute renal failure after trauma.[ncbi.nlm.nih.gov]

Symptoms start abruptly and consist of abdominal, flank, costovertebral or lower back pain, nausea, vomiting, fever and sometimes oliguria and hematuria. Blood pressure may be high during the acute episode.[symptoma.com]

Of the clinical symptoms, pain was present in 81 of 89 (91%) cases, vomiting in 40%, fever in 49%, and oliguria in 16%.[journals.lww.com]

Blood workup in suspected renal infarction patients should include a complete blood cell count that may show leukocytosis [8], elevated levels of lactate dehydrogenase, [9], creatinine, blood urea nitrogen, as well as, C-reactive protein and aminotransferases [2]. Fibrinogen level will be low and fibrin-degradation product levels will be high. Metabolic acidosis, hyperkalemia, and hypocalcemia may be encountered. Other causes of lactate dehydrogenase elevation, such as myocardial infarction, hemolysis or malignancy should be excluded. Urinary analysis will show macroscopic or microscopic hematuria [6] and proteinuria [2].

An electrocardiogram is useful in order to determine if atrial fibrillation, a risk factor for renal infarction, is present. Other imaging studies include spiral computer tomography, renal ultrasound, computer tomography or classical angiography and dimercaptosuccinic acid or diethylenetriamine penta-acetic acid radioisotope scan. Computer tomography is used to exclude nephrolithiasis [5] and other lesions. It shows a typical wedge-shaped parenchymal opacification defect, while angiograms are capable of highlighting the occluded vessel [10]. Seldom, the renal vein may also be occluded. If contrast agents are used, the physician should consider their toxicity on an already compromised kidney and even order hemodialysis, if needed.

The infarction usually involves both the cortical and medullary areas and extends into the renal capsule. Hematoma, if present, indicates kidney trauma or transection. If contrast enhanced computer tomography is performed eight to seventy-two hours after the infarction developed, the cortical rim sign appears: a thin rim of cortex is visualized, due to collateral perfusion. Ultrasound and contrast-enhanced ultrasound, although less precise, may show the absence of flow on color Doppler evaluation [11]. These methods are also capable of detecting preexisting infarctions, that appear as hyperechoic scar tissue. Scintigraphic imaging will show diminished or absent renal perfusion and function.

As a last resort, a kidney biopsy may be performed in order to establish the diagnosis and exclude malignancy, if the patient has no contraindications.

There was no difference in outcome for anticoagulation treatment with or without thrombolytics.[ncbi.nlm.nih.gov]

Conservative treatment was initially planned in consideration of the delayed diagnosis ( 3 hours), but the patient subsequently developed hypertension not controllable with anti-hypertensive drugs.[ncbi.nlm.nih.gov]

It is associated with poor prognosis in a high percentage of cases. OBJECTIVES: To describe the main clinical, biochemical and radiologic features and to determine which factors are associated with poor prognosis (death or permanent renal injury).[ncbi.nlm.nih.gov]

This study analyzed the clinical and laboratory findings of patients diagnosed with renal infarction to determine whether it affects short- or long-term renal prognosis.[ncbi.nlm.nih.gov]

We describe the clinical features and renal prognosis of ARI in Japanese patients. METHODS: This single-center, retrospective, observational study included 33 patients with newly diagnosed ARI (2009-2013).[ncbi.nlm.nih.gov]

The most common etiology was atrial fibrillation. Computed tomography determined the specific cause for RI in 5 patients (13%) and a possible etiology in 17 (45%). Exact correlation with previous series was limited by methodological diversity.[ncbi.nlm.nih.gov]

The etiology was found to be renovascular in both patients, involving the occlusion of small renal arteries and causing SRI.[ncbi.nlm.nih.gov]

Fourteen patients (60.8%) with RI had atrial fibrillation (AF) as an etiologic factor of which four had concomitant mesenteric ischemia at diagnosis.[ncbi.nlm.nih.gov]

The etiologic study was only positive to factor V Leiden. In spite of the diagnosis and treatment it resulted in atrophy of the affected renal area.[ncbi.nlm.nih.gov]

Pathophysiologic mechanisms include direct cocaine-induced platelet activation in combination with vasoconstriction and endothelial damage. There is no proven therapy for this complication.[ncbi.nlm.nih.gov]

Pathophysiology of renal damage in cocaine users is multifactorial, and it has been postulated that the right kidney was more prone to ischaemia. Left kidney represents an extremely unusual site of cocaine-related renal infarction.[ncbi.nlm.nih.gov]

We emphasize the importance of recognizing potential symptoms early to prevent additional renal injury. Caution should be taken with deformities around the origin of the renal arteries and great vessels, especially in patients with atherosclerosis.[ncbi.nlm.nih.gov]

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